Proskauer - ERISA Practice Center

Third Circuit Says ERISA Administrative Appeal Denial Letters Must State Plan-Imposed Time Limits

The Third Circuit recently held that ERISA administrative appeal denial letters must include plan-imposed time limits for commencing a lawsuit challenging the claim denial, and the failure to provide such notice warranted…more
| Civil Procedure, Commercial Law & Contracts, Finance & Banking, Labor & Employment Law

Sixth Circuit Enforces Subrogation Clause

The Sixth Circuit rejected a participant’s argument that the plan’s subrogation provision was not enforceable because it was only in the plan’s summary plan description, and not in the trust agreement that the participant argued…more
| Civil Procedure, Finance & Banking, Labor & Employment Law

New Final Regulations and FAQs Provide Guidance on Preventive Services Coverage

Through new FAQs and final regulations, the U.S. Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (the “Departments”) have further clarified various issues related to the preventive care coverage…more
| Health, Labor & Employment Law

New IRS Guidance on 40% Excise Tax Previews Future Regulatory Complexity

Although public opposition to the 40% excise tax on high-cost health care is rapidly growing, the IRS continued to develop a regulatory framework for administration of the excise tax through its issuance of Notice 2015-52 on…more
| Health, Labor & Employment Law, Taxation

Eleventh Circuit Again Affirms Dismissal of Stock Drop Claim Against Delta Air Lines

The Eleventh Circuit affirmed dismissal of ERISA breach of fiduciary claims against Delta Air Lines and other alleged plan fiduciaries in connection with a defined contribution plan’s investments in Delta Air Lines stock. In…more
| Civil Procedure, Finance & Banking, Labor & Employment Law, Securities Law

No Damages Awarded for ERISA Plan Fund Mapping Claims

Mapping in a 401(k) plan occurs when an investment option is removed and the participant’s investment in that option is transferred to a different investment option (absent direction from the participant). On remand from the…more
| Civil Procedure, Civil Remedies, Finance & Banking, Labor & Employment Law, Securities Law

ACA Reporting Update: New Forms, Higher Penalties & Other Guidance

With the impending deadline early next year, most applicable large employers are (or should be) in the process of gearing up for what is perhaps the biggest Affordable Care Act (“ACA”) compliance challenge this year — the…more
| Labor & Employment Law, Health

Third Circuit Rules That Actual Harm Needed for Monetary Equitable Remedy

The Third Circuit recently held that a plaintiff was not entitled to a monetary, equitable remedy under ERISA § 502(a)(3) where he failed to prove actual harm. Perelman v. Perelman, Nos. 14–1663, 14–2742, 2015 WL 4174537 (3d…more
| Civil Procedure, Civil Remedies, Constitutional Law, Finance & Banking, Labor & Employment Law

Trade Act Reinstates Expired Health Coverage Tax Credit (HCTC)

On July 6, 2015, President Obama signed the Trade Preferences Extension Act of 2015. Among other things, the Trade Act retroactively reinstated the Health Coverage Tax Credit (HCTC), which had previously expired on January 1,…more
| Bankruptcy, Health, Insurance, Labor & Employment Law, Taxation

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were…more
| Health, Insurance, Labor & Employment Law

Agencies Issue Final Regulations on the Summary of Benefits and Coverage (SBC) Requirements

As promised in the FAQ issued on March 30, 2015, the U.S. Departments of the Treasury, Labor and Health and Human Services (the Departments) have issued final regulations regarding the summary of benefits and coverage (SBC) and…more
| Health, Insurance, Labor & Employment Law

District Court Rules Privately-Held Stock Plan Fiduciary May Have Affirmative Duty To Disclose

A federal district court in Georgia held that plan fiduciaries of a closely-held company’s single stock ERISA fund may have a duty to disclose material, non-public information concerning the value of the company’s shares when…more
| Finance & Banking, Labor & Employment Law, Mergers & Acquisitions, Securities Law

Ninth Circuit Affirms Dismissal of ERISA Section 510 Claim

The Ninth Circuit affirmed the dismissal on summary judgment of Plaintiff Rosemarie Cole’s claim that her employer, Permanente Medical Group, interfered with her receipt of pension benefits in violation of ERISA § 510…more
| Civil Procedure, Labor & Employment Law

Supreme Court Denies Review of Fourth Circuit Loss Causation Case

The U.S. Supreme Court recently declined to grant certiorari to review the Fourth Circuit’s decision in RJR Pension Investment, et al. v. Tatum, 761 F.3d 363 (4th Cir. 2014). As we previously reported, a divided panel of the…more
| Civil Procedure, Labor & Employment Law, Finance & Banking, Securities Law

U.S. Supreme Court Says “Regular Review” of ERISA Investments Required

ERISA plan fiduciaries charged with responsibility for selecting, monitoring or removing plan investment options should pay close attention to the U.S. Supreme Court’s recent ruling in Tibble v. Edison Intl., 135 S. Ct. 1823…more
| Civil Procedure, Labor & Employment Law, Finance & Banking, Business Torts
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